The role of 18F-FDG PET/CT for detecting nodal metastases in cN0 head neck cancer patients:a Meta-analysis
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摘要: 目的: 探讨18F-脱氧葡萄糖PET/CT(18F-FDG PET/CT)对cN0头颈部肿瘤患者颈淋巴结转移的诊断价值。方法:[HTSS]对电子数据库(PubMed、EMBASE、Cochrane Library、万方、CNKI数据库)进行系统检索。诊断性试验质量评价体系用来对纳入的研究进行质量评价。应用Meta-Disc 1.4软件进行Meta分析。结果:[HTSS]Meta分析共纳入8项研究。对以患者数为单位的数据,18F-FDG PET/CT的合并敏感性(SEN)、特异性(SPE)、诊断比值比(DOR)、阳性似然比(+LR)、阴性似然比(-LR)分别为0.61(95%CI 0.52~0.69)、0.74(95%CI 0.68~0.78)、9.62(95%CI 2.49~37.22)、3.22(95%CI 1.55~6.71)和0.42(95%CI 0.24~0.37)。曲线下面积为0.804 1。采用Cochrane-Q检验和I2 检验对DOR结果进行异质性分析,得到Q=21.26(P<0.05),I2 =81.2%。结论:[HTSS]Meta分析表明,18F-FDG PET/CT没有提供比CT/MRI更优的诊断准确率来检测cN0头颈部肿瘤颈淋巴结转移。考虑到所包含研究存在的异质性较高,PET/CT的潜在价值尚需在未来的研究中得到验证。
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关键词:
- 18F-脱氧葡萄糖PET/CT /
- 头颈部肿瘤 /
- 临床颈淋巴结阴性 /
- Meta分析
Abstract: Objective: The aim of this study is to evaluate the accuracy of 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) for the diagnosis of cervical node metastases in cN0 head neck cancer patients. Method: An electronic database search(PubMed,EMBASE,Cochrane Library,WanFang and CNKI databases)was performed. Updated quality assessment of diagnostic accuracy studies-2 (QUADAS-2) was used to assess study quality. Data analyses were performed with Meta-Disc 1.4. Result: Eight studies were included in the present Meta-analysis. For patient-specific data,the pooled sensitivity,specificity,diagnostic odds ratio(DOR),positive likelihood ratio(PLR),and negative likelihood(NLR)for 18F-FDG PET/CT were 0.61(95%CI 0.52-0.69),0.74(95%CI 0.68-0.78),9.62(95%CI 2.49-37.22),3.22(95%CI 1.55-6.71),and 0.42(95%CI 0.24-0.37),respectively. The area under the curve(AUC)was 0.804 1. The evaluation of heterogeneity,calculated the pooled diagnostic odds ratio,gave a Q value of 21.26(P<0.05)and an I2 of 81.2%.Conclusion: The results of meta-analysis suggested that 18F-FDG PET/CT did not provide better diagnostic accuracy than CT/MRI in detecting cervical node metastases in cN0 head and neck cancer. Considering the high heterogeneity of the included studies,potential value of PET/CT needs to be validated in future studies. -
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